In total, the nuclear medicine community relies on a wide suite of medical isotopes. There are approximately 200 isotopes available for use. Each isotope has its own characteristics and the ability to provide doctors with a window into what is happening inside the body.

An isotope known as fluorine-18 is attached to a tracer to make a radiopharmaceutical. It is then injected into the patient where it moves throughout the body depending on the tracer. In Canada, PET/CT scans use the radiopharmaceutical flurodeoxyglucose (FDG). Approximately 60 minutes after injection, the scanning part of the procedure begins.

“FDG is a sugar and the sugar is burned up by different parts of the body at different rates,” according to Dr. Neil Alexander, executive director of the Fedoruk Centre. “In nuclear medicine, particularly in diagnostics, if you have a sugar it goes around the body and anything burning up the sugar at a great rate lights up on the scan. As one example, cancer cells burn up sugar at a greater rate than healthy cells, allowing physicians to detect cancers and see how the disease responds to treatment.”

PET/CT scans provide doctors with vital information on the location and extent of cancer within the body. The test also allows doctors to assess the success of treatments; providing patients with a better chance at survival.

Parkinson’s disease diagnosis and research is one of the newest areas for medical isotopes and PET/CT. Early diagnosis in the case of Parkinson’s is an important step to increasing knowledge on how the disease progresses and responds to therapy. In the case of Parkinson’s patients the scan is looking for a decrease in proteins used in the synapses, or the junctions between nerve cells, in the brain.

Until the cyclotron started producing isotopes, patients requiring a scan in Saskatchewan needed isotopes flown in from Ontario and because the radioactivity is short-lived, meaning FDG cannot be stored, daily shipments were required. The challenges of early morning production added to air transportation often led to delayed starts and cancellations, providing unreliability for patients in need of medical diagnoses.

“Up until now, all of it was coming in from Hamilton and a lot of the material had decayed so they couldn’t process as many patients,” says Alexander.

Producing locally means more reliable health care for patients, cutting wait times and diagnosing more patients sooner. It also means that Saskatchewan medical researchers have a supply readily available to expand their research programs.

HER2-positive breast cancers are less responsive than other cancer types to hormone treatment. Drugs like trastuzumab (Herceptin) and lapatinib (Tykerb) are effective but costly. Other treatments get used first – and may not work.

The Fedoruk research, if successful, would help doctors to identify HER2-positive cancer more readily and to prescribe effective treatment – saving time, money and lives.

Dr. Humphrey Fonge, an adjunct professor in the Department of Medical Imaging at the University of Saskatchewan, is leading the research that will better identify the protein, or biomarkers, on therapy-resistant cells, like HER2.

“When a patient goes to a clinic, they would get injected with a radiopharmaceutical that would more accurately tell which protein is responsible for that cancer and that would allow the physician to more accurately determine treatment to a particular drug rather than a one-size-fits-all method,” he said.

The research is still in the animal-testing phase. Humphrey estimates it will take a “few years” before it goes to Health Canada for approval.

“It’s going to be revolutionary. It will save a lot of costs. If a patient goes to a clinic and is treated with a $70,000 drug and they don’t respond to drug, that’s a loss of $70,000.”

Not only will the imaging agent help to determine which drug therapy should be used, but it will also be able to monitor how patients respond to that therapy.

Neil Alexander, executive director of the Saskatoon-based Fedoruk Centre, said nuclear imaging is helping in cancer research as well in the fields of heart and brain research.

He calls it an area of expertise the Fedoruk Centre is developing through the Saskatchewan Centre for Cyclotron Sciences, which is leading to “great breakthroughs around the world.”

“The developments that are taking place in nuclear imaging will mean that our children will not be as terrified of diseases like cancer as we were because we will know so much more about them,” he said.

“Our ability to image them will give us that much more data both about the processes that cause cancer and how we can disrupt them and the ways that we can then treat them in order to minimize their consequences.”

Alexander said a large part of modern life would not be possible but for the development of innovative nuclear technology.

“The industry is hugely broad based and the innovations have led to the foundations of modern society,” he said.

By John StewartDirector, Policy and ResearchCanadian Nuclear Association

Sylvia Fedoruk and Dr. Harold Johns with an early cobalt-60 machine.

Northern Saskatchewan has been leading in nuclear technology since the early 1950s. That’s when researchers at the University of Saskatchewan pioneered cobalt-based therapy for cancer.

One of those researchers was a student named Sylvia Fedoruk, the medical physicist and oncologist who also contributed to the development of nuclear medical scanning systems.

Today, the Saskatoon-based Fedoruk Centre for Nuclear Innovation funds a wide range of research initiatives in nuclear technology, many of them in the health sciences.

The 2014 nuclearFACTS event on November 20.

Last week the Fedoruk Centre hosted two back-to-back events. On November 20, nuclearFACTS presented funded projects in nuclear research, development and training in Saskatchewan in the areas of nuclear medicine, nuclear energy and safety, materials research and environmental studies. It drew a total of about 80 participants.

And the following day, the Accelerate workshop, which CNA proudly sponsored, provided a day of discussion of nuclear research, innovation and financing. The researchers shared knowledge of fields from veterinary medicine to applied physics to venture finance.

The inaugural Accelerate workshop on November 21.

A central theme coming out of this wide-ranging discussion was that nuclear technologies are “both new and old.” Like steam engines in the 1820s, electricity in the 1920s, or telephony in the 1980s, nuclear today has been around for decades – yet may be just beginning to find its most powerful applications.